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General NPI Number Information
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NPI Number | 1023431145
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Entity Type | Organization
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Legal Business Name | CELTICARE HEALTH PLAN OF MASSACHUSETTS, INC.
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Dates
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Enumeration Date | 01/24/2014
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Last Update Date | 01/24/2014
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Provider Practice Location Address
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Address Line | 200 WEST ST
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City | WALTHAM
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State | MA
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Zip | 02451-1121
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Country | US
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Telephone | 617-779-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 200 WEST ST
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City | WALTHAM
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State | MA
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Zip | 02451-1121
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Country | US
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Telephone | 617-779-5100
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Fax |
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Authorized Official
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Title or Position | SR. DIRECTOR, ETHICS AND COMPLIANCE
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Name | SUSAN R. KOHLER
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Credential | RN,BSN, MSML
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Telephone | 770-743-3252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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